COVID-19 Health Check List

Prior to coming to the Charleswood 55 Plus Active Living Centre please review the following health questionnaire:

1. Are you experiencing any of the following symptoms with an unknown cause?

  • Fever or chills

  • Cough

  • Sore throat

  • Runny nose

  • Weakness

  • Headache

  • Shortness of breath or difficulty breathing

  • Cold or flu like symptoms

  • Loss of smell of lasting more than 2 days


2.  Is anyone sick in your household with the above mentioned symptoms?

3.  Have you been diagnosed with, or had contact with any person diagnosed with or being tested for    COVID-19 in the last 14 days?

4.  Have you or any member of your household travelled outside of Manitoba in the last 14 days? (MB residents who have travelled to Western Canada, the territories or Northwestern Ontario are exempt)

5.  Have you or anyone in your household been instructed to self-isolate due to travel, or COVID-19 in the last 14 days?


If you have answered YES to any of the above symptoms or questions you cannot enter the Charleswood 55 Plus Active Living Centre. Please stay home.